So it’s been a while, hasn’t it? Many of us working in healthcare have been strained to say the least. Even if we aren’t dealing directly with patients with the coronavirus or their families, the rapidly changing and always dramatic day-to-day events in our country and around the world are more than enough for anyone to handle.
Rather than post an essay or some helpful “how-to-cope” stuff, I’m just going to write. Which is a way of coping in itself. Pardon any possible incoherence.
March was horrible. As the virus escalated around the United States our information on it through the CDC and state health department escalated as well. Information received one day contradicted what was heard the day before. We understood that this was due to the rapidly evolving nature of our knowledge as well as our response, but it was still frustrating. Many of the facilities I go to rapidly started to close their doors to visitors as well as hospice staff. The situation changed sometimes by the hour. For example one of my facilities which was closed opened back up and allowed me to go back in. When I got there though to visit my patient there, I wasn’t allowed in. When I asked when the change happened, the person at the door said “as of now”.
The situation with the facilities has been perhaps the most frustrating professionally. Each facility has their own guidelines and protocols in place. Some allow all staff to visit provided they wear a mask and have their temperature checked at the door. Others will only allow the RN and then only once every 14 days, which is the least they can do in order to keep someone on hospice. Some facilities have much higher standards than others as well: last week I went to a facility which requires masks for all staff, but I found that hardly any wore them properly. Nursing staff talked to me with their mask down around their chin. One even handed me the thermometer when I entered and said “you know what to do”. Others require you to spray your shoes when you go in, or wear a hair covering as well as a mask.
These facilities run the gamut as well from small assisted living facilities to skilled nursing homes and senior living communities. My situation is such that, being that I’m not in a hospital or dedicated hospice facility, my environment is much less under my control. Some facilities act with an overabundance of caution while others shrug at state recommendations and do just enough to get by.
The toll has been hardest on the families of those we care for. Most aren’t allowed to visit due to restrictions. For example, one family is struggling greatly with the fact that they can’t visit their mom as they had done every day for years. Another worried that her mother who suffers from dementia would forget her. One husband is angry and isolated in his apartment, knowing that he can’t visit his wife in the dementia care unit which is part of his own senior community. Many struggle with their inability to care for themselves in the ways they had in the past. Anxieties are high, as is confusion and anger over state regulations and restrictions. Some aren’t getting a lot of information about how their loved ones are doing, or if there are sick people in the building. Some can’t even do “window visits” as their loved one’s room may be three or floors up. Because my visits are more limited I’ve been asked to do more family calls to make sure they’re doing ok. A surprising amount are. Many say that they appreciate the restrictions as being evident of the concern a facility has for their residents. When they can, facilities will set up a FaceTime or video chat with a resident and their family, and this helps a great deal, but it doesn’t happen across the board. We are trying to do this as well for our patients and our families greatly appreciate it.
Some of my patients as well are suffering because of all the restrictions in place. No visitors also often means no volunteer visits, no pet therapy, no large group activities, no clergy visits. And yet those who can will tell me that they understand the reason the restrictions are in place, and while they are discouraged it hasn’t overwhelmed them. A big part of this I think is the fact that many of those I see went through periods of great deprivation and came out on the other end of them. When they can keep in touch with family and others, they do much better.
While our income as a company hasn’t changed – our census has remained fairly steady over the past three months – our workload has. Several employees took voluntary furloughs and others took involuntary ones. We’ve all had to change and adjust caseloads and cover new territories. We’re all trying to do more with less.
There’s a toll on our staff as well. While we aren’t working with COVID-19 patients, we are all affected by it and have very limited control over where, how and even if we can perform our jobs. It’s often frustrating. On top of that many of my coworkers know people who have been affected directly by coronavirus, whether through illness or job loss from the related shutdown. Like me, some are trying to teach and raise our kids while working. Others our trying to care for parents who are sick. I get worried about bringing back illnesses from the places I go to – especially when facilities have lax procedures in place. Sometimes this worry, stress and anxiety boils over, but not very often. Social media has been more a source of anger and frustration at times. Choosing your messages, not only those I send but those I receive, has been helpful there.
So that’s about all I can think of for now. I know we’re all so ready for things to go back to normal, but normal is gone. Just like 9/11, “normal” is not something recoverable. The restrictions and annoyances we experience now in travel and security lines are the new normal. So we’re still trying to figure out what normal will be. We as a nation are going through grief, and not always doing it well, because we don’t grieve well.
But this is not all glum and sadness. Overall I have to say that I and my family are doing well. This has been a very challenging time, and thankfully it hasn’t hit us as hard as many others. I’m enjoying not having to wake up to an early alarm clock most mornings. I am thankful that I can help others and that I can feel some security in terms of what I do. I’m trying to take better care of myself. Our gas consumption has gone down dramatically. My company has done a tremendous job of not only making sure we are safe but that we feel valued and cared for.
I think I can summarize by saying that all of us are trying our best, however that best looks.